Abstract
Objectives:
Increased posterior tibial slope (PTS) is a known risk factor for anterior cruciate ligament (ACL) injury and incidence of concomitant meniscal tears. However, the impact of PTS on the severity of concomitant meniscal injury has not been investigated. Therefore, our aim was to characterize the association between PTS and concomitant meniscal injury severity among patients with ACL injury.
Methods:
We retrospectively identified patients who underwent primary ACL reconstruction at a single institution from 2015-2021. Patients were excluded for multiligament injury, MRI >12 weeks before surgery, or >1 year between injury and surgery. We collected patient demographics, preoperative course, surgical details and measured medial and lateral PTS. The primary outcome was the presence of a high severity meniscus tear at time of arthroscopy, defined as a medial or lateral complex, bucket-handle, root, or Zone 3 radial tear. We determined the association between PTS and high severity meniscus tears using univariate and logistic regression.
Results:
We included 219 patients (47.0% female, age 25.3 ± 10.3 years, BMI 25.6 ± 4.5 kg/m2) in the analysis. Eighty-three patients (37.9%) underwent a medial meniscus procedure while 110 patients (50.2%) underwent a lateral meniscus procedure. Mean medial PTS was 4.3 ± 2.8° and mean lateral PTS was 5.0 ± 3.1°. The rate of high severity meniscus tear was 11.4% or 11.0% for a medial or lateral meniscus tear, respectively. BMI was positively associated with medial or lateral high severity meniscus tears (OR 1.122, 95% CI 1.041-1.210, p=0.003). Neither medial nor lateral PTS were associated with high severity meniscus tears (all p>0.05).
Conclusions:
PTS was not associated with high severity meniscus tears in patients undergoing ACL reconstruction within one year of injury. While BMI was an independent factor associated with meniscus tear severity, delays in surgery did not increase the odds of severe meniscus tear incidence when taking into account PTS.